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Thread: Vaccine Questions

  1. #1

    Default Vaccine Questions

    AAPC: Back to School
    I have a couple of questions regarding vaccine administration, please.....

    Is it correct that when reporting vacicnes, you are to report the CPT code for the vaccine product first followed by the CPT code for the administration? Am I correct that the product code(s) have higher RVUs that the administration code(s)?

    If a Medicare patient presents for the flu vaccine (G0008) and then another vaccine is administered (let's say polio), then do you report 90472 or 90471 for the second vaccine? Would you need a modifier 59 on the second admin code?

    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P
    Compliance Auditor

  2. Default Vaccines

    We use the 90472 for the second vaccine. Since the code indicates its a 2nd administration you wouldn't need the 59.

  3. #3



    Do you report the product code(s) first, then the administration code(s)?
    Last edited by dballard2004; 11-08-2010 at 11:10 AM.
    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P
    Compliance Auditor

  4. #4


    Also, can someone please explain the NCCI edits regarding Medicare and vaccines? I know that you report the G codes for the administration of the flu, pneumonia, and Hepatitis B vaccines, but I notice an NCCI edit for 90471 and the G codes and 90472 and the G codes.

    The mutually exclusive edits show 90471 listed twice as being bundled in G0008, G0009, and G0010. One edits shows they can be bypassed with a modifier (1) and the other edits hows they can't be bypassed at all (0). Can someone please interpt this please? Can you report these together or not?

    Can someone provide me with an example of when you would use 90471 in conjunction with G0008, please?

    Also, the mutually exclusive edits show 90472 bundled into the G codes with a "0" indicating you can't bypass the edits. So how do you report additional vaccines? Thanks.
    Last edited by dballard2004; 11-08-2010 at 02:36 PM.
    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P
    Compliance Auditor

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